摘要目的 探讨碳酸酐酶Ⅸ蛋白在乳腺癌分子分型中的表达及其意义.方法 采用免疫组织化学MaxVision法检测117例乳腺浸润性导管癌中雌激素受体(ER)、孕激素受体(PR)、HER2、CK5/6、表皮生长因子受体(EGFR)、碳酸酐酶Ⅸ的表达.结果 浸润性导管癌患者年龄25 ～ 71岁,平均49.6岁.117例中分5型:管腔A型66例(56.4％)、管腔B型6例(5.1％)、HER2过表达型10例(8.6％)、基底细胞样型20例(17.1％)、未分类型15例(12.8％).碳酸酐酶Ⅸ在管腔A型和基底细胞样型乳腺癌中的表达比例分别为13.6％ (9/66)和8/20,差异有统计学意义(P＜0.05).管腔A型中碳酸酐酶Ⅸ的阳性表达率,肿瘤最大径＞2 cm组(7/27,25.9％)明显高于≤2 cm组(2/39,5.1％),差异有统计学意义(P＜0.05).碳酸酐酶Ⅸ在组织学3级(18/50,36.0％)中的表达明显高于1级(2/21,9.5％)和2级(7/46,15.2％),差异有统计学意义(均P=0.006).碳酸酐酶Ⅸ表达阴性的病例中,ER和PR的阳性率分别为61.1％ (55/90)和55.6％ (50/90)；碳酸酐酶Ⅸ表达阳性的病例中,ER和PR的阳性率分别为37.0％(10/27)和29.6％(8/27).碳酸酐酶Ⅸ表达阴性组激素受体的阳性率均明显高于阳性表达组,二者差异有统计学意义(均P＜0.05).结论 碳酸酐酶Ⅸ表达不仅与乳腺浸润性导管癌的分子分型有关,还与组织学分级、激素受体表达情况、肿瘤大小有关.碳酸酐酶Ⅸ是乳腺癌预后差的相对独立的标志物.

abstractsObjective To study the expression of carbonic anhydrase (CA) Ⅸ and its significance in molecular subtyping of breast carcinomas.Method MaxVision immunohistochemical staining was used to examine the expression of ER,PR,HER2,CK5/6,EGFR,and CA Ⅸ in 117 cases of breast invasive ductal carcinomas.Results The patients' age ranged from 25 to 71 years (mean 49.6 years).All the 117 cases were subclassified into five subtypes,with 66 (56.4％) luminal A,6 (5.1％) luminal B,10(8.6％) HER2 positive,20(17.1％) basal-like,and 15(12.8％) unclassified tumors.The expression of CA Ⅸ in luminal A and basal-like breast cancers was 13.6％ (9/66) and 8/20,respectively,with a significant difference (P ＜ 0.05).Among the luminal A cancers,the expression of CA Ⅸ in tumors ＞ 2 cm (7/27,25.9％) was significantly (P ＜ 0.05) higher than that of tumors ≤2 cm (2/39,5.1％).The expression of CA Ⅸ in grade 3 invasive ductal carcinoma (18/50,36.0％) was significantly higher than that in grade 1 (2/21,9.5％) and 2 (7/46,15.2％) tumors (both P =0.006).In CA Ⅸ-negative of invasive ductal carcinoma,the expression of ER and PR was 61.1％ (55/90) and 55.6％ (50/90),respectively; whereas in CA Ⅸ-positive cancers,the expression of ER and PR was 37.0％ (10/27) and 29.6％ (8/27),respectively.The expression of hormone receptors in CA Ⅸ-negative tumors was significantly higher than that in CA Ⅸ-positive tumors (for both ER and PR,P ＜ 0.05).Conclusions The expression of CA Ⅸ correlates not only with molecular subtypes of breast cancer,but also with the grading,hormone receptors and diameter of mammary invasive ductal carcinoma.CA Ⅸ is a relative independent marker of poor prognosis in breast cancer.